ABSTRACT
Aim: Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder. It affects women's physical well-being and leads to great psychological distress. Indeed, women with PCOS show a compromised quality of life as well as impaired emotional well-being. The aim of this study is to assess personality characteristics, body image and alexithymia in women with PCOS. Materials and methods: A total of 59 women with PCOS and 38 healthy controls were administered the Toronto Alexithymia Scale (TAS), the Body Uneasiness Test (BUT) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Results: The PCOS group showed higher values of alexithymia and a higher body uneasiness. They also showed higher values on many clinical, content and supplementary scales of the MMPI-2. Discussion: It seems that physical appearance and bodily function have a central place in the minds of women with PCOS, as well as in their relationships. However, it is a body they find it hard to feel and with which they mostly feel uncomfortable. Their approach to the outside world seems to be characterized by a certain degree of immaturity, anger, hostility and distrust. Low self-esteem also seems to be connected to a certain tendency toward introversion and withdrawal. This leads to problems in social, professional and intimate relationships.
Subject(s)
Affective Symptoms/psychology , Body Image/psychology , Personality/physiology , Polycystic Ovary Syndrome/psychology , Adult , Female , Humans , MMPI , Prospective Studies , Psychiatric Status Rating Scales , Quality of Life/psychology , Self Concept , Young AdultABSTRACT
Besides its growth hormone-releasing effect, ghrelin has been demonstrated to influence other hormonal systems, such as the hypothalamo-pituitary-adrenal axis, prolactin secretion, the thyroid axis as well as the gonadal axis. Ghrelin and its analogues stimulate the hypothalamo-pituitary-adrenal axis independent of the pituitary, via the hypothalamus, involving both corticotrophin-releasing hormone, arginine-vasopressin and neuropeptide Y stimulation. In adrenocortocotropic hormone (ACTH)-secreting tumors, the ghrelin receptor is pathologically expressed, thus accounting for especially high ACTH and cortisol responses to ghrelin and GH secretagogues in patients with Cushing's disease. Ghrelin stimulates prolactin release most probably from the somatomammotroph cells of the pituitary gland. The effect of ghrelin on the pituitary regulation of the thyroid axis is controversial and its role in the physiological control of thyroid function is still matter of investigation. On the other hand, ghrelin has been reported to exert an inhibitory effect on follicle-stimulating hormone and, in particular, on luteinizing hormone, probably via an inhibitory effect exerted at the hypothalamic level on gonadotropin-releasing hormone secretion.
Subject(s)
Ghrelin/physiology , Growth Hormone/metabolism , Neurosecretory Systems , Animals , Ghrelin/genetics , Ghrelin/pharmacology , Gonads/drug effects , Gonads/metabolism , Gonads/physiology , Humans , Hypothalamo-Hypophyseal System/drug effects , Hypothalamo-Hypophyseal System/metabolism , Lactotrophs/drug effects , Lactotrophs/metabolism , Lactotrophs/physiology , Neurosecretory Systems/drug effects , Neurosecretory Systems/metabolism , Neurosecretory Systems/physiology , Pituitary-Adrenal System/drug effects , Pituitary-Adrenal System/metabolism , Thyroid Gland/drug effects , Thyroid Gland/metabolism , Thyroid Gland/physiologyABSTRACT
INTRODUCTION: Sexual dysfunction in women with diabetes, despite its important consequences to their quality of life, has been investigated only recently with conflicting results about its prevalence and association with complications and psychological factors. AIMS: To assess the prevalence of the alteration of sexual function and the influence of metabolic control and psychological factors on female sexuality. METHODS: Seventy-seven adult Italian women with type 1 diabetes, matched with a control group (n=77), completed questionnaires evaluating sexual function (Female Sexual Function Index, FSFI), depressive symptoms (Self-Rating Depression Scale, SRDS), social and family support (Multidimensional Scale of Perceived Social Support), and diabetes-related quality of life (Diabetes Quality of Life). Clinical and metabolic data were collected. MAIN OUTCOME MEASURES: Prevalence and magnitude of sexual dysfunction in terms of alteration of sexual functioning as measured by the FSFI scores. RESULTS: The prevalence of sexual dysfunction was similar in diabetes and control groups (33.8% vs. 39.0%, not significant), except for higher SRDS scores in the diabetes group (47.39 ± 11.96 vs. 43.82 ± 10.66; P=0.047). Diabetic patients with an alteration of sexual function showed a significantly higher SRDS score (53.58 ± 14.11 vs. 44.24 ± 9.38, P=0.004). Depression symptoms and good glycemic control (A1C<7.0%) were predictors of alteration of sexual function only in diabetic patients (odds ratio [OR]=1.082; 95% confidence interval [CI]: 1.028-1.140; OR=5.085; 95% CI: 1.087-23.789), since we have not found any significant predictor of sexual dysfunction in the control group. CONCLUSIONS: The prevalence of sexual dysfunction in our type 1 diabetes patients' sample is similar to those reported in other studies. Diabetic patients are similar to healthy people except for higher depression scores. Further studies are necessary to understand whether the correlation between an alteration of sexual function and good glycemic control may be related to the role of control as a mental attitude.
